Organization
GAYLE GOZDOR, PH.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLE ANN GOZDOR PH.D. (CLINICAL PSYCHOLOGIST)
(313) 730-2077
Entity
Organization
Contact information
Practice address
2881 MONROE ST, SUITE 201C, DEARBORN, MI 48124-3475
(313) 730-2077
(248) 562-7719
Mailing address
2881 MONROE ST, SUITE 201C, DEARBORN, MI 48124-3475
(313) 730-2077
(248) 562-7719
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301007615
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F30675
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/10/2008
Last updated
09/26/2011
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